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Updated: Sep 13, 2025
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Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
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The central lymph node dissection using carbon nanoparticle in transoral vestibular approach endoscopic thyroid
Hui Li1, Zeyang Liu1, Wu Li2
1Department of Thyroid Surgery, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410006, Hunan, China.
Scientific Reports
|August 3, 2025
Summary
Carbon nanoparticle (CN) use in transoral endoscopic thyroidectomy vestibular approach (TOETVA) improves small lymph node detection for thyroid cancer. This minimally invasive technique shows comparable lymph node clearance to open thyroidectomy (OT).
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Endocrine Surgery
Background:
- Minimally invasive approaches like transoral endoscopic thyroidectomy vestibular approach (TOETVA) are increasingly used for thyroid cancer.
- Accurate lymph node assessment is crucial for staging and treatment planning in differentiated thyroid cancer (DTC).
- Carbon nanoparticle (CN) has been explored to enhance visualization during surgical procedures.
Purpose of the Study:
- To evaluate the clinical application value of carbon nanoparticle (CN) in TOETVA for differentiated thyroid cancer (DTC).
- To compare the lymph node retrieval and detection rates between TOETVA with CN and conventional open thyroidectomy (OT).
- To provide evidence for the efficacy of CN in improving lymph node detection in minimally invasive thyroid surgery.
Main Methods:
- A prospective study involving 110 DTC patients from September 2019 to January 2020.
- Patients were divided into an experimental group (TOETVA with CN, n=80) and a control group (OT, n=30).
- Lymph nodes were categorized by size (<5 mm and ≥5 mm), and retrieved lymph nodes (RLN), row retrieved lymph nodes (RRLN), and positive central lymph nodes (PLN) were recorded and analyzed.
Main Results:
- No significant differences were observed in the proportion of RRLN, RLN, PLN, positive rate (PR), and lymph node positivity between the TOETVA and OT groups.
- Smaller lymph nodes (<5 mm) yielded significantly more RRLN and RLN compared to larger lymph nodes (≥5 mm) within the same group.
- In the TOETVA group, RRLN was significantly higher than RLN, and CN use improved the detection rate of small lymph nodes.
Conclusions:
- The lymph node clearance efficacy of TOETVA with CN is comparable to conventional OT.
- Carbon nanoparticle (CN) enhances the detection of small lymph nodes during TOETVA.
- The use of CN is recommended in TOETVA procedures to improve lymph node assessment in thyroid cancer patients.
